when should you call kepro?

• If you are not ready to be discharged from the hospital.
• If your Medicare skilled services are ending too soon. Examples of skilled services include things like physical therapy and nursing services.
• If you have a concern about the quality of care you received.
• If you have a concern about your medical care that needs to be taken care of right away.

Click on the link below for the phone number for your state. These services are free for people who have Medicare. 

Kepro Telephone Numbers 

january is glaucoma awareness month

Learn about glaucoma. Glaucoma has no early symptoms – that’s why so many people don’t know that they have it.

There’s no cure for glaucoma, but early treatment can often stop the damage and protect your vision.  

Read more from the National Eye Institute: www.nei.nih.gov

Order a free booklet that was written especially for those people who were recently diagnosed with glaucoma: www.glaucoma.org

Watch videos from the National Eye Institute to learn more about glaucoma.

have you gotten your flu shot?

If you haven't, there's still time. The flu shot is the best way to protect you and your loved ones against the flu and its potentially serious complications.

Read more about the flu shot, including how to find locations near you where you can get a flu shot, on our flu page.

Medicare covers the flu shot and the updated 2023-2024 COVID-19 vaccines. People with Medicare Part D (drug coverage) can also get vaccines for shingles, whooping cough, and more at no cost.

immediate advocacy services can help when you need an answer from your healthcare provider right away

Immediate Advocacy is a free service for people with Medicare. It is used to help people quickly resolve problems about medical care or services. Immediate Advocacy often involves Kepro calling a healthcare provider or facility on behalf of the patient.

This month, our Immediate Advocacy example is also a reminder about your yearly flu shot.

Let’s look at a situation where Kepro’s free Immediate Advocacy services were able to quickly help solve an issue with communication.

Rozalyn went to her local pharmacy and asked if they tested for flu. She thought she just had a bad cold, but alas, the flu test was positive. The next step was for the pharmacist to get a prescription (doctor’s order) for an antiviral medicine from Rozalyn’s primary care doctor.

Getting prescriptions from Rozalyn’s doctor’s office hadn’t been an issue in the past, but this time, the pharmacist had a hard time getting a response from the physician's office.

The pharmacist sent a prescription request to Rozalyn’s primary care doctor along with a copy of the positive test results, but the office was closed. 

The pharmacist called the doctor’s office the next morning. The pharmacist explained that Rozalyn tested positive for flu and needed to begin an antiviral medicine right away. The doctor’s office staff said that they would leave the request on the doctor’s desk for when she got in.

After a few hours, there was still no word from the doctor’s office. As it sometimes happens, the doctor became busy with patients and the request was still on the doctor’s desk and had not been answered.

The pharmacist remembered reading about Kepro’s Immediate Advocacy services for people who have Medicare in Kepro’s newsletter. She called Rozalyn and suggested they contact Kepro together. They would be able to use Immediate Advocacy to quickly work through this problem.

While on the phone with Kepro, the pharmacist and Rozalyn explained the situation. To help resolve the issue, Kepro called the doctor’s office right away. The facts were explained about the positive flu test and the urgency of the prescription request. Thankfully, with Kepro’s help, the prescription made its way from pending on the doctor’s desk and into the pharmacist’s hands. Rozalyn was finally able to get the medicine she needed in time for it to work. 

If you are on Medicare and are not happy with the care you received, or if you need help working through an issue that needs to be taken care of right away, please call Kepro and ask about Immediate Advocacy services.

Rozalyn’s example of Immediate Advocacy is also a reminder to get your flu shot and to get tested if you suspect you could have the flu.

Why should you get tested for flu?

If you think you may have the flu, you may be able to get tested at your local pharmacy. 

If you test positive for the flu, do not despair! An antiviral medicine, if taken within a couple of days, may be able to shorten the time that you’re sick. Less tissues and downtime? Yes, please!

Flu viruses typically spread in fall and winter, with activity peaking between December and February. The Centers for Disease Control and Prevention (also referred to as the CDC) has information on their website to help you: What are the symptoms of flu versus the symptoms of a cold?

For your convenience, you can also read more about the flu on Kepro’s flu page.

ADDITIONAL INFORMATION

What you should know about flu antiviral drugs. (Centers for Disease Control and Prevention)

Similarities and differences between flu and COVID-19. (Centers for Disease Control and Prevention)

Read about Immediate Advocacy services on Kepro's website.

how to protect yourself from medicare fraud and abuse

In every issue, Kepro tries to include updates and news related to Medicare. In the past few newsletters, facts about Medicare Open Enrollment were highlighted. Hopefully you found the information helpful in making your healthcare choices for 2024!

This month, we wanted to share information about how to protect yourself from Medicare fraud and abuse.

Medicare fraud and abuse … awful, right?

Regrettably, it happens more often than you think.

• Medicare fraud happens when a person or company knowingly tricks Medicare. They do this to get wrongful payments from the program.
• Medicare abuse happens when providers seek Medicare payments that they don’t deserve. However, this can happen without knowingly or intentionally having done so. Abuse can also involve billing for unsound medical practices. 

The good news is that you can do your part to stop Medicare fraud by keeping your Medicare card safe.

keep your medicare card safe

1. If you get a call, text, or email asking for your Medicare number, don't respond! Don't give your Medicare card or Medicare number to anyone except your doctor or people you know should have it. It is very important to know that Medicare will never call you unprompted and ask you for your personal information.
2. Check your Medicare Summary Notices or claims statements carefully. If you see a charge for a service that you didn't get or a product you didn't order, it may be fraud.
3. If you suspect fraud, report it by calling 1-800-MEDICARE (1-800-633-4227).

more information

• Senior Medicare Patrols empower and assist people who have Medicare, their families, and caregivers to prevent, detect, and report healthcare fraud, errors, and abuse.
• Reporting Medicare fraud and abuse (www.Medicare.gov)

Publication No. R146810-330-12/2023. This material was prepared by Kepro, a Medicare Quality Improvement Organization under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy.